Cheney's Brain: A Legacy of Little Strokes?

The Washington Post's series on Vice President Dick Cheney is compelling reading, and it has two more installments to go [parts one and two, more extensive than the versions in the Strib, are here].

A question I've often pondered about the Vice President's health is posed in an online Q&A with series co-author Barton Gellman. Gellman, who has worked on this story for
about a year, chooses not to speculate on Cheney's health and repeats
what he says in print — Cheney has remained consistent; it's his access
to power to that's the difference:

Preston, Minn.: I have seen patients that have had startling
and profound personality changes following coronary events and other
life threatening health problems. Has there been any evidence Cheney
has had such an effect? I remember reading a quote by someone to the
effect he is no longer the person he once was.

Barton Gellman:
There have been two main grounds of speculation that Cheney has changed
fundamentally: grave health threats and the experience of 9/11 itself.
We can't see inside his head, so we can't know. But I don't think you
need either theory. Cheney's views have been remarkably stable over the
years; what's changed is his power to apply them. Brent Scowcroft
famously said "Dick Cheney, I don't know any more" (that's pretty close
if not verbatim). I'd submit that the Dick Cheney he knew had about the
same views in the first Bush administration, but lost many of the
internal debates to Scowcroft, Jim Baker and of course President Bush
(41) himself.

In other words, we shouldn't worry about
diminished capacity or personality disorder, because the Vice President
seems to be operating according to long-held principles. But talk to
people who spend their days with heart patients instead of Washington
politics, and you may hear a more cautionary view.
Years ago, a cardiologist friend remarked how the nation might be
truly worried if they could see a scan of Cheney's brain. Cheney has
long suffered from serious arterial disease,
most recently manifested in a deep vein thrombosis in March. Both his
condition and the effects of surgical treatment could starve the blood
supply to regions of the brain.
Earlier this year, The New Republic said as much:

"Wear and tear on your arteries is
converted to wear and tear on your brain," says Merrill Elias, an
epidemiologist and psychologist with Boston University and the
University of Maine specializing in the heart-brain connection. "People
develop infarcts — areas of the brain that are dead because they've been
deprived of blood supply. They have little strokes they're not even
aware of."

[...]

"Very often, the symptoms of vascular
dementia's cognitive impairment are brought on by stress," notes Elias,
adding that such troubles are often "accompanied by anger and mood
changes."
[...]A 2003 study by researchers at the
University of Maryland, meanwhile, showed that patients suffering from
peripheral artery disease performed significantly worse than others on
seven tests measuring a range of cognitive abilities, including
concentration, manual dexterity, and executive function (the ability to
control one's behavior by managing other brain functions like complex
problem-solving and emotional response).

I've scanned historical photos of Cheney,
trying to determine whether his characteristic left-sided snarl is a
long-standing expression or might be evidence of one of those little
strokes. Hard to say conclusively, but it seems to make an early
appearance in this photo from 1987, a year before his third heart
attack and quadruple bypass surgery.
It might be comforting to assign Cheney's dark performance as Vice
President to undisclosed health issues. But the terrible truth may be America got exactly what it elected — George W. Bush propped up between Dick Cheney and Karl Rove — and it was the nation that suffered the silent series of strokes that now imperil us.

Comments

The Washington Post's series on Vice President Dick Cheney is compelling reading, and it has two more installments to go [parts one and two, more extensive than the versions in the Strib, are here].

A question I've often pondered about the Vice President's health is posed in an online Q&A with series co-author Barton Gellman. Gellman, who has worked on this story for
about a year, chooses not to speculate on Cheney's health and repeats
what he says in print — Cheney has remained consistent; it's his access
to power to that's the difference:

Preston, Minn.: I have seen patients that have had startling
and profound personality changes following coronary events and other
life threatening health problems. Has there been any evidence Cheney
has had such an effect? I remember reading a quote by someone to the
effect he is no longer the person he once was.

Barton Gellman:
There have been two main grounds of speculation that Cheney has changed
fundamentally: grave health threats and the experience of 9/11 itself.
We can't see inside his head, so we can't know. But I don't think you
need either theory. Cheney's views have been remarkably stable over the
years; what's changed is his power to apply them. Brent Scowcroft
famously said "Dick Cheney, I don't know any more" (that's pretty close
if not verbatim). I'd submit that the Dick Cheney he knew had about the
same views in the first Bush administration, but lost many of the
internal debates to Scowcroft, Jim Baker and of course President Bush
(41) himself.

In other words, we shouldn't worry about
diminished capacity or personality disorder, because the Vice President
seems to be operating according to long-held principles. But talk to
people who spend their days with heart patients instead of Washington
politics, and you may hear a more cautionary view.
Years ago, a cardiologist friend remarked how the nation might be
truly worried if they could see a scan of Cheney's brain. Cheney has
long suffered from serious arterial disease,
most recently manifested in a deep vein thrombosis in March. Both his
condition and the effects of surgical treatment could starve the blood
supply to regions of the brain.
Earlier this year, The New Republic said as much:

"Wear and tear on your arteries is
converted to wear and tear on your brain," says Merrill Elias, an
epidemiologist and psychologist with Boston University and the
University of Maine specializing in the heart-brain connection. "People
develop infarcts — areas of the brain that are dead because they've been
deprived of blood supply. They have little strokes they're not even
aware of."

[...]

"Very often, the symptoms of vascular
dementia's cognitive impairment are brought on by stress," notes Elias,
adding that such troubles are often "accompanied by anger and mood
changes."
[...]A 2003 study by researchers at the
University of Maryland, meanwhile, showed that patients suffering from
peripheral artery disease performed significantly worse than others on
seven tests measuring a range of cognitive abilities, including
concentration, manual dexterity, and executive function (the ability to
control one's behavior by managing other brain functions like complex
problem-solving and emotional response).

I've scanned historical photos of Cheney,
trying to determine whether his characteristic left-sided snarl is a
long-standing expression or might be evidence of one of those little
strokes. Hard to say conclusively, but it seems to make an early
appearance in this photo from 1987, a year before his third heart
attack and quadruple bypass surgery.
It might be comforting to assign Cheney's dark performance as Vice
President to undisclosed health issues. But the terrible truth may be America got exactly what it elected — George W. Bush propped up between Dick Cheney and Karl Rove — and it was the nation that suffered the silent series of strokes that now imperil us.